“The diabetic who knows most will live the longest” – Dr. Elliot P Joslin
Dietary discipline can prevent the risk of developing diabetes and avoid risks of complications of diabetes in known diabetics. Let me stress there is no ‘diabetic diet' per se. There is only a healthy eating plan within a caloric frame – that means eating in right amounts nutritious foods at specified times, according to one's age, weight, physical activity, medication, and special situations.
In Kerala about 17 per cent of the elderly are diabetic. The loss of farmland and more and more people turning for white collar jobs may perhaps be the contributing factor for this. Many of the newly discovered diabetics are between the age group of 35-40years. The sedentary life style and lack of dietary discipline aggravates the risk for diabetes.
An easy approach to following a disciplined dietary plan is to understand the food pyramid and food exchange lists. The following was developed by USDA for Asian immigrants in USA, and is very much applicable to any Indian diabetic. All the different kind of foods must be included daily, because different foods contain varying nutrients and a diabetic needs good amounts of vitamins and minerals for optimal carbohydrate metabolism.
Let us take a look at the basic guidelines for healthy eating.
• Fat - Overall oil consumption should not exceed 20 per cent of the total calories or not more than 40gms per day as recommended by the Indian Council of Medical Research (ICMR). Surprisingly some of the healthiest oils are what Indians traditionally use - mustard, sesame, groundnut, cottonseed. These are healthier than corn or safflower oils in the Indian context. Olive if locally available may be included in the daily diet. It is prudent to use a combination of oils as each has different proportion of saturated, monounsaturated and polyunsaturated fats.
• Carbohydrates – Sixty per cent of total calories from complex, high fibre carbohydrates.
Traditional vegetarian Indian diet which include coarse grains, whole wheat, kaffir corn, maize, ragi contain almost four times more fibre than refined cereals or processed foods. Eating high fibre foods gives better blood sugar control, is filling and reduces the need to snack frequently.
Refined sugar must be avoided, as they contribute nothing but empty calories and no nutritional benefit. Vegetables should form a regular and large part of the main meals. Include fresh and cooked vegetables.These contribute linolenic acid derivatives which is beneficial in reducing cholesterol.
Most importantly, cook vegetables in minimum oil, steaming, stewing or stir frying. Because it makes no sense if the nutritious fat free high fibre vegetables are deep-fried or drowned in coconut milk or malai! All fruits are good for the diabetic and should be an essential part of the meals or as in between snacks. Fruits contain fibre, vitamins and antioxidants that protect against cardiovascular diseases.
Another important source of carbohydrates is legumes which are high in the kind of glutinous fibre known to give better glycemic control and also reduce cholesterol. Legumes also contain minerals like magnesium and chromium which play a role in carbohydrate metabolism. The added benefit of legumes is that it is a major source of protein. This is beneficial to diabetic in avoiding sudden ups and drops in blood glucose levels. Legumes are caloric dense, but they give you carbohydrates and protein all at once, so I would suggest including them in every meal and as a substitute of meats.
• Protein – we have talked about legumes as a source of protein. The healthiest non-vegetarian source of protein is fish, followed by lean meats like chicken and turkey. Red meats, sausages, ham, organ meats, egg yolk, poultry with skin on (as found in fast foods) contain saturated fats and therefore are a big NO, since diabetics are more prone to cardiovascular diseases.
Low fat cow's milk, buttermilk, paneer, cottage cheeses are essential in moderate amounts. Milk is a wholesome food providing protein, vitamins and minerals and also is one of the foods with the least glycemic index. Low fat cow's milk products make excellent between meal snacks.
